Gender-specific relationships between depressive symptoms, marijuana use, parental communication and risky sexual behavior in adolescence

The relationship between depressed affect, parental monitoring, and sex on cannabis use among American Indian youth

BACKGROUND AND OBJECTIVES

American Indian (AI) adolescents report higher rates of cannabis use than national US adolescents. Previous study examined interactive relationships between depressed affect and family factors on AI adolescent alcohol use. These factors have not been investigated for cannabis use. We examined whether parental monitoring dampened risk for cannabis use due to depressed affect, and potential moderation by sex.

METHODS

We measured cannabis use, depressed affect, parental monitoring, and sex among reservation area AI youth among students in grades 7-12 attending 45 schools. We used censor-inflated regression models to identify parental monitoring as a moderator of the relationship between depressed affect and cannabis use.

RESULTS

In the logistic portion of censor-inflated models, level of depressed affect and parental monitoring significantly related to last 30-day cannabis use. Higher levels of parental monitoring at lower levels of depressed affect related to lower likelihood of cannabis use. Female students had greater likelihood of endorsing cannabis use at higher levels of depressed affect. In the linear portion of the censor-inflated regression models, sex and level of parental monitoring significantly related to cannabis use frequency. Male students endorsed more frequent cannabis use while higher levels of parental monitoring related to lower frequency of use.

DISCUSSION AND CONCLUSIONS

Parental monitoring may dampen the effect of depressed affect on cannabis use among AI youth on reservations.

SCIENTIFIC SIGNIFICANCE

Future interventions should foster skill-building prevention efforts directed at coping with depression, along with parental training for effective monitoring. Special attention to AI female adolescents may be indicated.

Determining Positive Behavioral Skills in Different Age Groups of Young Basketball Players during the Pandemic

Assessing psychological indicators such as positive behavioral skills in the context of adolescent personality development during the pandemic era is highly relevant: the growing problem of peer disrespect among adolescents who participate in sports has recently become an undeniable scientific issue. This study aimed to analyze positive behavioral skills in the cadet (U16) and junior (U18) age groups of young basketball players during the COVID-19 pandemic. The participants were 378 male athletes (age 16.36 ± 1.15 years). Results revealed that U18 athletes are more capable of taking responsibility, positively evaluating themselves, behaving pro-socially with teammates, cooperating, demonstrating assertiveness, demonstrating self-control, and managing emotions than U16 adolescent athletes. When comparing the effect sizes in the current study during the pandemic with similar studies by other authors, the pandemic may have had a larger negative effect on some positive behavioral skills (ability to control emotions, social responsibility skills, cooperation skills) in U16 athletes than in U18 athletes, as the effect sizes were small before the pandemic and moderate during the pandemic in the current study. This study's results may be useful for developing and implementing a young athletes' education program based on a comprehensive model of positive behavioral skills that include the indicators analyzed.

A Systematic Review of Parent-Child Communication Measures: Instruments and Their Psychometric Properties

Parent-child communication represents an important variable in clinical child and family psychology due to its association with a variety of psychosocial outcomes. To give an overview of instruments designed to measure the quality of parent-child communication from the child's (8-21 years) perspective and to assess the psychometric quality of these instruments, we performed a systematic literature search in Medline and PsycInfo (last: February 25, 2022). Peer-reviewed journal articles published in English with a child-rated instrument measuring the quality of parent-child communication were included. Initial screening for eligibility and inclusion, subsequent data extraction, and quality assessment were conducted by couples of review team members. Based on the screening of 5115 articles, 106 studies reported in 126 papers were included. We identified 12 parent-child communication instruments across the studies. The Parent-Adolescent Communication Scale (PACS) was used in 75% of the studies. On average, the evidence for psychometric quality of the instruments was low. Few instruments were used in clinical and at-risk samples. Several instruments are available to rate parent-child communication from the child's perspective. However, their psychometric evidence is limited and the theoretical foundation is largely undocumented. This review has limitations with regard to selection criteria and language bias.Registration PROSPERO: CRD42021255264.

The Social Side of Sleep: A Systematic Review of the Longitudinal Associations between Peer Relationships and Sleep Quality

In adolescence, peer relationships become crucial since youths start to rely on their peers for support. Thus, multiple facets of adolescents' well-being are affected by their peer relationships. In this vein, one of the central well-being aspects that could be affected by the peer relationships of adolescents is sleep quality. Nevertheless, it is still unclear how multiple peer relationship factors (i.e., positive, negative, emotional, and behavioral issues related to peer relationships) are intertwined with adolescents' sleep quality. For this reason, this systematic review with meta-analysis aims to summarize longitudinal studies to uncover how the interplay between peer relationship factors and adolescents' sleep quality unfolds over time. Nineteen longitudinal studies involving a total of 21,232 adolescents were included. Overall, findings from this review showed that (a) positive peer relationships and sleep quality were not associated over time; (b) negative peer relationships and sleep quality were bidirectionally associated over time; (c) few studies evaluated the bidirectional relations between emotional and behavioral issues and sleep quality, showing links with sleep schedule and duration, but not with sleep quality. Meta-analytic results were discussed, considering their implications.

A Formal Appraisal About High-Risk Sexual Behaviour on the Pretext of Substances Use Among Indian Men

All behaviors' that satisfy a person's biological needs and desires are considered sexual behaviors. Despite the fact that sexual behavior and expression are universal to all animals, especially humans, the context in which the behaviors are expressed may make it risky or even dangerous. High risk sexual behaviors' and substance use disorders are frequently been linked. This study's main goal is to investigate the relationship between substance use by Men and their participation in high risk sexual behaviors. In the current study data were taken from NFHS 5 (2019-2021) and methods like Pearson's chi-squared test, bivariate and multivariate binary logistic regression models were used to established the relationship that risky sexual behavior is a consequence of substances use. Result revealed that Men's alcohol consumption in daily basis is strongly associated with premature sex (AOR: 1.05; 95%CI: 1.08-1.26; p < 0.05), sex with multiple partners (AOR: 2.35; 95%CI: 1.86-2.97; p < 0.05), and unprotected sexual intercourse (AOR: 2.06; 95%CI: 1.91-2.19; p < 0.05). Apart from alcohol consumption smoking cigarette, use of smokeless tobacco, and use of guthka are also significantly associated with risky sexual behavior of Men on Women. The concern of substances use among Indian men may be dwindled through adoption of appropriate footsteps like incorporating moral education in school curriculum; upbringing socio-economic status; more socialization; increasing social awareness among individual or community through mass media exposure like print or virtual media even which may ultimately reduce the practice of risky sexual behaviour.

Risky sexual behaviour among Russian adolescents: association with internalizing and externalizing symptoms

BACKGROUND

Risky sexual behaviour (RSB) is regarded as a major health problem during adolescence. Russia has one of the highest rates of teenage pregnancy, abortion and newly diagnosed HIV infections in the world, but research on RSB in Russian youth has been limited. To address this deficit, this study examined the role of several factors, including internalizing and externalizing symptoms, in RSB among Russian adolescents.

METHODS

Self-reported data were collected from 2573 Russian adolescents aged 13-17 years old (59.4 % girls; Mean age = 14.89) regarding RSB (unprotected sex, early pregnancy, multiple sexual partners and substance use during sexual encounters). Information was also obtained on externalizing (conduct problems and delinquent behaviour) and internalizing (depression, anxiety and posttraumatic stress) symptoms, as well as interpersonal risk and protective factors (affiliation with delinquent peers, parental involvement and teacher support). Hierarchical multiple binary logistic regression analysis was used to examine the associations between these variables and RSB.

RESULTS

Boys reported engaging in more RSB than girls. Externalizing symptoms and affiliation with delinquent peers were most strongly associated with RSB, whereas symptoms of anxiety were negatively associated with RSB. There was an interaction effect for sex and affiliation with delinquent peers on RSB with boys reporting RSB when having more delinquent peers. Neither parental involvement nor teacher support were protective against RSB.

CONCLUSIONS

Early detection of and interventions for RSB and associated externalizing symptoms may be important for adolescent physical and mental wellbeing. Affiliation with delinquent peers should, especially among boys, be regarded as a risk marker for RSB.

Risk factors for alcohol, marijuana, and cigarette polysubstance use during adolescence and young adulthood: A 7-year longitudinal study of youth at high risk for smoking escalation

INTRODUCTION

Alcohol, nicotine, and marijuana are the three most widely used substances among adolescents and young adults, with co-use of multiple substances being common. Few longitudinal studies have examined risk factors of alcohol, marijuana, and nicotine poly-substance use. We examined frequency of alcohol, marijuana, and cigarette poly-substance use over time and how key risk factors contribute to this substance use during adolescence and young adulthood.

METHODS

Participants (N = 1263 9th and 10th graders) were oversampled for ever-smoking a cigarette at baseline from 16 Chicago-area high schools between 2004 and 2006. Many participants progressed to heavier cigarette use, as well as alcohol and marijuana use over time. Participants completed questionnaires assessing substance use and psychosocial factors at baseline, 6-, 15-, 24-, 33-months, and 5-, 6-, and 7-years.

RESULTS

Longitudinal multi-level models demonstrated that at baseline and over time, more depression symptoms, more anxiety symptoms, negative mood regulation expectancies, and lower grade point average (GPA) were each associated with more poly-substance use over time. In addition, there were a number of interaction effects of gender (e.g., depression was related to substance use in males) and developmental stage moderated these relationships.

CONCLUSIONS

Depression, anxiety, negative mood regulation expectancies, and GPA all significantly influence both initial and longitudinal levels of substance use across adolescence and young adulthood. Our findings underscore the importance of identifying and treating youth with depression and anxiety symptoms, as well as providing resources early for those struggling in school in order to help with substance use prevention and intervention efforts.

Adolescents' Health Literacy and Decision-making: A Qualitative Study

Objective: Adolescents assume increased responsibility for their health, particularly regarding health decision-making for lifestyle behaviors. Prior research suggests a relationship between health literacy (HL) and health behaviors in adolescents. Yet, the specific role of HL in adolescents' health decision-making is unclear. This study qualitatively explored adolescents' use of HL in their health decision-making. Methods: Six focus groups with adolescents (N = 37, M_age = 16.49, 86% girls) were conducted. Adolescents' responses to questions about their HL use were coded using thematic analysis. Results: Adolescents identified passive and active HL engagement and several individual (eg, future orientation, risk perception) and environmental (eg, access to resources/information, media) factors that influenced their use of HL in health decision-making. Feedback from others, subjective health, and ability to navigate multiple sources of information also determined adolescents' confidence in their HL skills. Conclusions: Our results support expanding the types of HL studied/measured in adolescents and provide insight on how HL can be leveraged to improve adolescents' health decision-making. Though there was no guiding theory for this study, results support using the Information-Motivation-Behavior Skills model to assess the HL/health decision-making relationship in adolescence.

Optimizing Assessment of Risk and Protection for Diverse Adolescent Outcomes: Do Risk and Protective Factors for Delinquency and Substance Use Also Predict Risky Sexual Behavior?

Assessments of youth risk and protective factors (RPFs) for substance use, delinquency, and violence have been used by communities to identify priorities and target them with prevention interventions. These same RPFs may also predict other youth problems. This study examined the strength and consistency of relationships of 41 ecological RPFs that predict antisocial behavior and substance use with sexual behavior outcomes in a sample of 2150 urban youth in 10th and 12th grade. After adjusting for controls, findings identify significant associations among the majority of community, school, family, peer, and individual risk factors, and family, peer, and individual protective factors, with sexual behavior outcomes, specifying unique associations among multiple factors with risky sex relative to both safe sex and not being sexually active. Prevention programming that targets common predictors for multiple problems may address a broad array of outcomes, including sexual health risk behaviors.

Exposure to sexually explicit media in early adolescence is related to risky sexual behavior in emerging adulthood

Background

Sexually explicit media exposure during early adolescence has been found to be associated with risky sexual behavior. However, previous study suffered from methodological issue, such as selection bias. Furthermore, little is known about the effect of multi-modality sexually explicit media exposure on risky sexual behavior, and how this relationship can be applied to non-western societies.

Objectives

This study aimed to improve upon previous studies by using instrumental variable estimation. In addition, this study also included multi-modality of sexually explicit media and three risky sexual behavior measure from a sample of Taiwanese adolescents.

Methods

Participants were recruited from a prospective longitudinal study (Taiwan Youth Project). All were in 7^th grade (mean age = 13.3) when the study was initiated in 2000. Sexually explicit media exposure, including ever-exposure and number of modalities exposed to, was measured in wave 2 (8^th grade). Risky sexual behavior was measured in waves 8 (mean age = 20.3) and 10 (mean age = 24.3). A two-stage least squares regression was employed, with pubertal timing as the instrumental variable.

Results

About 50% of participants had been exposed to sexual media content by 8^th grade, from an average of one modality. Sexually explicit media exposure predicted early sexual debut, unsafe sex, and multiple sexual partners (all: p < .05). Furthermore, exposure to more media modalities increased the likelihood of risky sexual behaviors. However, only the effect on early sexual debut was gender invariant.

Conclusions

Exposure to sexually explicit media in early adolescence had a substantive relationship with risky sexual behavior in the emerging adulthood. Knowledge of this causal like effect provides a basis for building better preventive programs in early adolescence. One prominent way is early education on media literacy, and physicians themselves may need to be familiar with such content to initiate it.

Evaluation of an Online Sexual Health Program among Adolescent Girls with Emotional and Behavioral Difficulties

OBJECTIVES

Adolescent girls with emotional and behavioral difficulties (EBDs) have a heightened risk of negative sexual health, including HIV, other sexually transmitted infections (STIs), and unplanned pregnancy. Few evidence-based sexual health interventions are available for adolescent girls with EBDs. This study tested the feasibility, acceptability, and efficacy of a brief, online sexual health program called HEART (Health Education and Relationship Training).

METHODS

Forty-seven participants (M-age = 15.79; SD = 1.71; 62% Black, 23% Hispanic) recruited from community-based organizations in the southeastern U.S. were compared to a non-equivalent comparison group who received an attention-matched intervention.

RESULTS

Findings support the feasibility of participant recruitment and program administration in community-based settings. Participants completed HEART in 44 minutes and experienced few technological difficulties. HEART was highly acceptable: most participants liked, learned from, and were engaged with the program. Further, 92% would recommend HEART to a friend and 98% would use what they learned in the future. At posttest, intervention participants had significantly higher communication intentions, communication skills, STI/HIV knowledge, sexual self-efficacy, condom attitudes, and condom norms than the comparison group (ps < .003; effect size ds = .38-1.65). Significant improvement in condom intentions was observed when comparing pretest to posttest scores among intervention participants only, t(46) = -3.21, d = 0.47.

CONCLUSIONS

Findings support the feasibility, acceptability, and efficacy of HEART among adolescent girls with EBDs in community-based settings. This study also addresses the growing need for research into the transferability of sexual health interventions to facilitate evidence-based decision-making about program dissemination and implementation.

Precocious and Problematic? The Consequences of Youth Violent Victimization for Adolescent Sexual Behavior

PURPOSE

Violent victimization is concentrated in adolescence and is disruptive to both the timing and sequencing of key life course transitions that occur during this developmental stage. Drawing on recent work establishing the interpersonal consequences of youth victimization, we examined the effect of violent victimization on adolescents' timing of sexual debut and involvement in additional sexual risk behaviors (multiple sexual partnering and inconsistent contraceptive use).

METHODS

This study relied on secondary data analysis of 10,070 youth from four waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health). To predict sexual debut and subsequent sexual risk-taking, analyses were limited to youth not yet sexually active at their wave I interview.

RESULTS

Findings from Cox proportional hazards models, negative binomial regression, and repeated measures ordinal logistic regression showed that adolescent victims of violence initiated sex sooner than non-victims and accumulated more sexual partners, but patterns varied by age at victimization. Youth victimized in late adolescence displayed an accelerated trajectory of sexual activity while youth victimized in early adolescence were less likely to debut or engage in other sexual risk behaviors (although younger victims were more likely to engage in other deviant activities).

CONCLUSION

Sexual activity is a normative part of adolescent development, yet this study finds that violent victimization may disrupt the timing of this life course task, exacerbating deviant risk-taking and undermining youths' subsequent well-being. This study also highlights the importance of life course criminology's attention to timing in lives, given that the consequences of victimization varied by the age when it occurred.

High-risk sexual behaviour in young people with mental health disorders

AIM

This study aimed to determine the prevalence of high-risk sexual behaviours, sequelae and associated factors in young people attending a youth mental health service.

METHODS

The study design was a cross-sectional survey of 103 young people aged between 15-25 years carried out across four specialist mental health clinics. A questionnaire on the sexual health of secondary level students was adapted for this study. Mental health symptomatology was assessed through the Brief Psychiatric Rating Scale (BPRS).

RESULTS

The mean age was 20.9 (SD ±2.8) years, with 50.5% being female, 41.7% male and 7.7% transgender. A total of 52.4% (N = 54) attended the psychosis [EPPIC] clinic; 15.6% (N = 16) attended the ultra-high risk for psychosis [PACE] clinic; 19.4% (N = 20) attended the personality disorders [HYPE] clinic; and 12.6% (N = 13) attended the mood clinic [YMC]. The mean BPRS score was 47.7 (SD ±12.2). A total of 77.7% of young people had previously been sexually active and of these, 37.5% did not use consistent contraception; 26.3% had been pregnant, of which 95.2% were unplanned. A total of 68.8% reported having been tested for sexually transmitted infections and 25.5% tested positive. The severity of symptoms or clinical characteristics were not associated with engagement in high-risk sexual behaviours.

CONCLUSIONS

These results indicate that young people with mental health disorders have high needs in regard to their sexual health, which could be addressed by incorporating sexual health referral pathways into early intervention services.

Analyzing the Association Between Depression and High-Risk Sexual Behavior Among Adult Latina Immigrant Farm Workers in Miami-Dade County

Latinas are often more affected by HIV due to their socio-economic and demographic profiles and are also less likely to receive proper mental health care. Latina immigrants are often even more vulnerable due to socio-economic and cultural factors that place them at higher risk. The current study seeks to examine the association between depression and risky sexual behaviors among adult Latina immigrants from a farm working community in South Miami-Dade County, (Florida, USA). Cross-sectional secondary data analysis was used for responses from a community-based participatory research (CBPR) study. Out of 234 Latina immigrants, 15% reported being depressed and 80% were reported as having engaged in risky sexual behavior. Although no association was found between depression and high-risk sexual behavior, significant secondary findings present associations between risky sexual behavior and low sexual relationship power, interpersonal violence, and relationship status. Implications for future research on depression and risky sexual behaviors among this population are discussed.

Sexual risk among African American girls seeking psychiatric care: A social-personal framework

OBJECTIVE

This study examined individual and social factors associated with sexual risk behavior among African American girls seeking outpatient mental health services across 2 years and key developmental transitions.

METHOD

African American females 12-16 years old (M = 14.5; SD = 1.15; n = 266) were recruited from eight outpatient mental health clinics and completed interviewer-administered and computer-assisted measures at baseline, 12, and 24 months. Analyses tested individual attributes (externalizing and internalizing problems) and family context (maternal acceptance-rejection, mother-daughter communication about sex) at baseline, peer influences (peer support of substance use, girlfriend dating behavior) and partner relationship characteristics (rejection sensitivity, partner risk communication frequency and openness) at 12 months, and girls' sexual behavior at 24 months.

RESULTS

At baseline, 32% of girls reported having had vaginal/anal sex compared with 60% at 24 months. Data analyses revealed robust associations between externalizing problems and maternal acceptance-rejection and mother-daughter risk communication during early adolescence, peer support of substance use and girlfriend dating behavior 1 year later, and girls' sexual risk taking 2 years later.

CONCLUSION

Findings support a social-personal framework (SPF) of sexual risk for African American girls seeking mental health care, underscoring the potential benefits of early intervention to reduce externalizing problems while strengthening mother-daughter communication and relationships to prevent subsequent sexual risk and associated negative outcomes. (PsycINFO Database Record

Defining “High-risk Sexual Behavior” in the Context of Substance Use

Introduction: Sexual behavior is a behavior exhibited by individuals to gratify one of their basic needs, that is the sexual need. Often the way in which sexual behavior is practiced may lead to negative consequences. However, the definition of a sexual behavior as risky varies with regards to culture, gender, age, and the threshold.

Objectives: This review aims to study different definitions of high-risk sexual behavior available in literature, the differences in the prevalence of various risks associated with risky sex in substance-using population as compared to general population, and eventually formulating a tentative definition of “high-risk sexual behavior” in the context of substance use. Current evidence and results of literature search as we have entered into the epidemic of human immunodeficiency virus globally, it is important clinically as well as from the public health perspective to define high-risk sexual behavior discretely helping the researchers quantify the burden and the clinicians focus on the population at risk. High-risk sexual behavior has often been discussed and studied in various studies till date. However, literature lacks a discrete definition of high-risk sexual behavior. Risky sex (or high-risk sexual behavior) has been variably defined in different studies. Majority of the definitions in the studies focus on sexually transmitted infection, especially human immunodeficiency virus. A few studies talk about unintended pregnancies or abortions.

Conclusion: The association between high-risk sexual behavior and substance use has been well established. Further research is warranted to obtain a definition which has greater precision and clinical utility, and which can be integrated in preventive and promotive pursuits.

Marijuana Use and Depressive Symptoms; Gender Differences in African American Adolescents

Introduction: This study aimed to examine gender differences in the bidirectional associations between marijuana use and depressive symptoms among African American adolescents. The study also tested gender differences in the effects of socioeconomic status, maternal support, and friends' drug use on adolescents' depressive symptoms and marijuana use. Methods: This is a secondary analysis of the Flint Adolescent Study (FAS). Six hundred and eighty one African American adolescents (335 males and 346 females) were followed for 3 years, from 1995 (mean age 16) to 1997 (mean age 19). Depressive symptoms (Brief Symptom Inventory) and marijuana use were measured annually during the follow up. We used multi-group latent growth curve modeling to explore the reciprocal associations between depressive symptoms and marijuana use over time based on gender. Results: Baseline marijuana use was predictive of an increase in depressive symptoms over time among male but not female African American adolescents. Baseline depressive symptoms were not predictive of an increase in marijuana use among male or female adolescents. Conclusion: Study findings suggest that male African American adolescents who use marijuana are at an increased risk of subsequent depressive symptoms. Interventions that combine screening and treatment for marijuana use and depression may be indicated for African American male adolescents.

Validation of a Spanish Questionnaire on Mobile Phone Abuse

Mobile phone addiction has attracted much attention recently and is showing similarity to other substance use disorders. Because no studies on mobile phone addiction had yet been conducted in Spain, we developed and validated a questionnaire (Cuestionario de Abuso del Teléfono Móvil, ATeMo) to measure mobile phone abuse among young adults in Spanish. The ATeMo questionnaire was designed based on relevant DSM-5 diagnostic criteria and included craving as a diagnostic symptom. Using stratified sampling, the ATeMo questionnaire was administered to 856 students (mean age 21, 62% women). The MULTICAGE questionnaire was administered to assess history of drug abuse and addiction. Using confirmatory factor analysis, we found evidence for the construct validity of the following factors: Craving, Loss of Control, Negative Life Consequences, and Withdrawal Syndrome, and their association with a second order factor related to mobile phone abuse. The four ATeMO factors were also associated with alcoholism, internet use, and compulsive buying. Important gender differences were found that should be considered when studying mobile phone addictions. The ATeMo is a valid and reliable instrument that can be used in further research on mobile phone abuse.

Gender-specific associations between involvement in team sport culture and canadian adolescents' substance-use behavior

Canadian adolescents have some of the highest rates of substance use in the world. The etiology of this phenomenon has not been fully explored, and one possible contextual determinant is involvement in sport activities that foster risk-taking behaviors through physical and social mechanisms. Using the 2013-14 Health Behaviour in School Aged Children (HBSC) study we therefore examined this hypothesis in a contemporary national sample of Canadian adolescents. The strength and direction of the relationship between sport and substance use varied by gender and substance, with team sport participation associated with increased binge drinking (RR 1.33 [95% CI 1.13-1.56] for boys, RR 1.21 [1.06-1.38] for girls) and use of smokeless tobacco (RR 1.68 [1.34-2.10] for boys, RR 1.32 [1.01-1.72] for girls), but with lower prevalence levels of cannabis use (RR 0.73 [95% CI 0.61-0.88]) and cigarette smoking (RR 0.79 [95% CI 0.70-0.89]) in girls alone. We also compared team sport athletes with high social involvement (sports team as primary peer group) and physical involvement (higher number of days/week physically active) to those with low involvement. For boys, the combination of high physical and high social involvement was associated with the highest risk, while high social involvement alone was associated with the greatest risk for girls. While team sport participation confers only a small increased risk for substance use, the prevalence of sport participation results in a large population impact. Given this fact, interventions such as education for parents and coaches and policies encouraging engagement in a variety of extracurricular activities should be explored.

Sex Differences in Contraception Non-Use Among Urban Adolescents: Risk Factors for Unintended Pregnancy

BACKGROUND

Contraception non-use among sexually active adolescents is a major cause of unintended pregnancy (UP).

METHODS

In this cross-sectional study we sought to identify overall and sex-specific correlates of contraception non-use using the 2015 Philadelphia Youth Risk Behavior Survey (YRBS) (N = 9540). Multivariate regression models were used to examine mental health, sexual activity, substance use, and violence indicators on reported contraception non-use among sexually active youth.

RESULTS

Marijuana use among boys and girls was a statistically significant risk factor for contraception non-use. Availability of illegal drugs on school property in the past year was also significantly related to contraception non-use among boys.

CONCLUSIONS

These results may inform overall and sex-specific adolescent programs to promote consistent contraception use among urban youth within school-based communities.

The association between alcohol use trajectories from adolescence to adulthood and cannabis use disorder in adulthood: a 22-year longitudinal study

BACKGROUND

Due to the increasing prevalence of cannabis use disorder (CUD), the impact of cannabis use on public health may be significant.

OBJECTIVE

The present study seeks the possible precursors (e.g., alcohol use) of CUD in order to minimize the potential negative consequences of CUD such as impaired coordination and performance.

METHOD

The Harlem Longitudinal Development Study included 674 participants (53% African Americans, 47% Puerto Ricans), with 60% females (n=405) from a six wave survey. We used a growth mixture model to obtain the trajectories of alcohol use from the mean ages of 14 to 36. To examine the associations between alcohol use trajectories and CUD, we used logistic regression analyses with the indicator of CUD as the dependent variable and the indicator of membership in each trajectory group as the independent variables.

RESULTS

A three alcohol use trajectory group model was selected. Male gender, higher frequency of cannabis use in adolescence, and a lower educational level were associated with an increased likelihood of having CUD. Membership in the increasing alcohol use group (OR=27.44, p < .01; AOR=15.54, p < .01) and the moderate alcohol use group (OR=10.40, p < .05; AOR=8.63, p < .05) were associated with an increased likelihood of having CUD compared with the membership in the no or low alcohol use group.

CONCLUSIONS

The findings of our study support the hypothesis that addressing alcohol use at an early age could impact later CUD.

"Just Take a Moment and Breathe and Think": Young Women with Depression Talk about the Development of an Ecological Momentary Intervention to Reduce Their Sexual Risk

STUDY OBJECTIVE

Depressed young women are at increased risk for adverse outcomes related to sexual behavior, including unintended pregnancy, HIV, and other sexually transmitted infections. Brief sexual risk reduction interventions have not targeted depressed young women's specific needs for affect management and impulse control. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We interviewed depressed young women ages 15-23 years engaging in sexual risk behavior about a proposed intervention approach. The approach was described as in-person counseling and cognitive-behavioral skills training, followed by an ecological momentary intervention (EMI) delivered via smartphone application for 4 weeks. The EMI would include reporting multiple times a day on affective states, self-efficacy for safer sex behavior, and sexual behavior, and receiving responsive messages to provide support and prompt use of cognitive-behavioral skills. Participants provided their perspectives on comfort, usability, burden, confidentiality, and potential efficacy of the EMI and recommended message content. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis.

RESULTS

Thematic saturation was reached with 16 interviews. Participants expressed positive opinions about the EMI. They believed that reporting at random times would help them to recognize their feelings, receiving the messages would be reassuring, and overall the smartphone application would be experienced as therapeutic. They desired a high degree of personalization of the message quality, style, and voice, and provided a wide variety of message content.

CONCLUSION

Depressed young women believed that a flexible, personalized approach to mobile momentary intervention for addressing the link between their symptoms and behavior would be acceptable, supportive, and effective in reducing sexual risk.

Risk-Taking Propensity in Older Adolescents: Internalizing Symptoms, Gender, and Negative Reinforcement

OBJECTIVE

Engagement in risk behaviors, including substance use, risky sex, and violence, tends to increase throughout adolescence into young adulthood. One motivational process that may underlie risk behaviors during adolescence is negative reinforcement. Moreover, gender and internalizing symptoms (e.g., depression and anxiety) may both convey risk for negative reinforcement-based risk taking. Along these lines, the aims of the current study were to (a) examine gender differences in negative reinforcement-based risk-taking propensity and (b) examine internalizing symptoms as a moderator of the relationship between gender and negative reinforcement-based risk-taking propensity.

METHOD

Participants included 103 youth between the ages of 18 and 21 (50.49% female, age M(SD) = 19.41(1.06)) who were recruited from a large Mid-Atlantic university between September 2013 and November 2014. Participants completed self-report assessments of internalizing symptomatology and a computerized behavioral analog assessment of negative reinforcement-based risk-taking propensity.

RESULTS

Results indicated that, overall, female older adolescents were riskier under conditions of negative reinforcement than male older adolescents. In addition, internalizing symptoms significantly moderated the relationship between gender and negative reinforcement-based risk-taking propensity such that the relationship between gender and negative reinforcement-based risk-taking propensity was nonsignificant at high levels of internalizing symptoms, and female gender was significantly positively predictive of heightened negative reinforcement-based risk-taking propensity at low levels of internalizing symptoms.

CONCLUSIONS

Thus, although female youth overall were riskier, the predictive utility of gender for negative reinforcement-based risk taking may be most relevant at low levels of internalizing symptoms. Results are discussed in terms of implications for future prevention and intervention.

Mental Health and Associated Sexual Health Behaviours in a Sample of Young People Attending a Music Festival in Melbourne, Victoria

Poor mental health has previously been associated with risky sexual health behaviours among young people internationally and in clinical samples, but little is known about this relationship in non-clinical settings. We conducted a cross-sectional survey with a convenience sample of 1345 Australians aged 15-29. Multivariable logistic regression was used to identify sexual health behaviours independently associated with recent poor mental health including contraception use, STI testing, sexting and age at first sexual intercourse. Recent poor mental health was reported by 29.7 % of participants and independently associated with female gender (OR 1.8; 95 % CI 1.4-2.4), not identifying as heterosexual (OR 3.0; 95 % CI 2.1-4.4) and young age at first sexual intercourse among female participants (OR 1.4; 95 % CI 1.0-2.0). Results suggest mental health is largely driven by variables other than sexual health behaviours, although youth mental health services should consider inclusion of sexual health promotion within the scope of their services.

[Relationship between family functioning and lifestyle in school-age adolescents]

OBJECTIVE

Risk behaviors in adolescents can lead to serious disorders, therefore the objectives of this work are to characterize the lifestyles of teenagers about substance use, sex, and road safety, and to meet socio-demographic factors associated with these.

METHOD

A cross-sectional, descriptive and correlational study was conducted with 204 school-age-children from 12 to 17 years, in 2013. They were given a validated questionnaire about sociodemographic, family functioning, and lifestyles such as substance abuse, sexual intercourse and road safety. A descriptive and multivariate analysis was performed by using multiple linear regression in the case of quantitative dependent variables, and binary logistic regression models in the case of binary categories. Data analysis was based on SPSS 20.0, with a significance level of p<0.05.

RESULTS

32.4% of students had smoked, and 61.3% had drunk alcohol. 26% of adolescent between 14-17 years had sexual intercourse; the average age of the first sexual intercourse was 14.9 years. 85.2% used condoms. 94.6% respected traffic signs, 77.5% used to wear a seat belt and 81.9% a helmet. Family functioning, as protective factor, was the variable more frequently associated to risk behaviour: smoking (OR=7.06, p=.000), alcohol drinking (OR=3.97, p=.008), sexual intercourse (OR=3.67, p=.041), and road safety (β=1.82, p=.000).

CONCLUSIONS

According the results, age, gender and family functioning are the main factors associated with the adoption of risk behaviors. This information is important for the development of public health policies, for instance health promotion at schools.

Directions of the relationship between substance use and depressive symptoms from adolescence to young adulthood

PURPOSE

Both substance use and depression are common in adolescence and often comorbid. Past research has produced conflicting results on whether there is a temporal relationship and if so, in which direction it operates and how it may vary by sex. The purpose of this paper is to explore the longitudinal, potentially bidirectional, relationships between high-frequency substance use and depressive symptoms from adolescence into young adulthood for males and females.

METHODS

Using data from the National Longitudinal Study of Adolescent to Adult Health we investigated longitudinal associations between high frequency substance use (alcohol, cigarettes, and marijuana) and depressive symptoms. The linear mixed effects models were stratified by sex and used a lagged measure of the dependent variable to test temporal relationships. A random intercept was used for respondent ID.

RESULTS

Increases in depressive symptoms were significantly associated with a later increase of about a half day in marijuana use frequency for males and nearly a two day increase in smoking frequency for females. Conversely, increases in smoking frequency were significantly associated with approximately a 0.6-point increase for females and 0.4-point increase for males in depressive symptoms at a later wave.

CONCLUSIONS

Results indicate a bidirectional relationship between smoking and depressive symptoms for females. For males, there was evidence supporting self-medication with marijuana and for smoking being associated with later increases in depressive symptoms. Results inform how substance use and depression screening, prevention and treatment efforts should be paired and targeted for males and females.

Dating Violence and Substance Use as Longitudinal Predictors of Adolescents' Risky Sexual Behavior

The objectives of this study is to examine dating violence perpetration and victimization (physical, psychological, and sexual) and lifetime substance use (alcohol, marijuana, and hard drugs) as longitudinal predictors of adolescents' risky sexual behavior across 1 year and to determine whether predictors varied across adolescents' gender and ethnicity. A sample of Caucasian, African American, and Hispanic male and female adolescents from seven public high schools in Texas (N = 882) participated. Adolescents completed self-report measures of dating violence, lifetime substance use, and risky sexual behavior at baseline and, 1-year later, completed a second assessment of their risky sexual behavior. Path analysis demonstrated that greater physical dating violence victimization, lifetime alcohol use, lifetime marijuana use, and age (being older) were all significant predictors of risky sexual behavior at the 1-year follow-up. These results did not vary across gender or the three ethnic groups (Caucasian, African American, and Hispanic). Overall, substance use was a longitudinal predictor of risky sexual behavior across the three ethnic groups, with physical dating violence victimization being the only type of dating violence longitudinally predicting risky sexual behavior. Prevention efforts should consider the roles of physical dating violence and substance use in preventing risky sexual behavior.

Integrating positive youth development and clinical care to enhance high school achievement for young people of color

Purpose

– High school completion is one of the strongest predictors of health and well-being. There is increased public attention on the challenges faced by young people of color and educational achievement. In particular, young men of color must navigate myriad stressors which often undermine their mental health, as well as their academic performance, including likelihood of graduation from high school that fare worse in academic outcomes than their female counterparts. The purpose of this paper is to examine the role of Step-Up, a positive youth development and mental health promotion program, created in collaboration with young people of color on their high school achievement as measured by grade point average (GPA).

Design/methodology/approach

– This exploratory pre-post study employed multivariate analysis of data drawn from a sample of 212 youth of color to examine student’s GPA before their involvement in Step-Up and the number of Step-Up groups they attend in the first year could improve their high school achievement.

Findings

– Results revealed an association between students participation in Step-Up, specifically having at least ten life skills group contacts, and significant increases in GPA.

Research limitations/implications

– High school achievement is measured by GPA, which might not be a clear indication of achievement since grades are not truly comparable across schools. The exploratory pre-post research design of this study, and the lack of control group, limits any references to causality but the descriptive changes in GPA demonstrate a statistical significance of Step-Up group participation and improved high school achievement. A potential next step is to design an experimental study that includes psychosocial and developmental mechanisms while examining the treatment effect of Step-Up vs students receiving standard of care.

Practical implications

– Programs that aid young people of color in increasing their GPA should acknowledge the multitude of stressors that youth in urban environments encounter by creating interventions targeting multiple ecological contexts. These preliminary analyses suggest how programmatic supports that are collaboratively designed with youth, such as Step-Up, may yield promising results in improving young people of color high school achievement.

Social implications

– To better serve adolescents experiencing serious academic and behavioral health challenges, there needs to be programs that offer intensive, short-term mental health support in school settings. Given the widespread risk factors that adolescents and particularly young men of color are facing, Step-Up is informed by both the developmental assets framework and the social development model and aims to provide youth with opportunities for prosocial interactions and additional resources to combat multiple stressors. Since successful completion of high school is associated with better outcomes as young people transition to adulthood, programs that are developmentally timed to allow for an optimal protective factor during the high school years is necessary.

Originality/value

– This research contributes to the knowledge base of the importance of providing mental health supports in school settings and may contribute to studies examining the academic achievement of young people of color in school settings.

Mutual relations between sleep deprivation, sleep stealers and risk behaviours in adolescents

Objectives

The aim is to evaluate the mutual influences between sleep duration/sleep deprivation (SD) and the sleep stealers/adolescent risk behaviours.

Methods

The national survey is a component of the Health Behaviour in School-Aged Children (HBSC) study, it is based on a school-based self-completed questionnaire; 3476 students were randomly selected from 139 randomly chosen Portuguese schools using as an unit the class, 53.8% were girls; 45.9% attended the 8th grade and 54.1% the 10th grade; the mean age was 14.9 years. The measured variables were: 1) gender and age; 2) sociodemographics; 3) sleep duration during the week and during weekends and computed SD; 4) screen time (computer use during the week and during the week end (PC use); watching TV and mobile phone use; 5) earlier sexual behaviour; 6) violent behaviours: fights, use of weapons; 7) use of tobacco, alcohol and drugs. The statistical analysis included Pearson chi-square tests and logistic regression.

Results

Excessive use of mobile phone, of computer use during weekdays, and internet facilities; substance use; violence and earlier sexual relations had significantly higher prevalence in sleep deprived adolescents. By logistic regression only using PC during weekdays, tobacco, drugs and weapons were associated to SD, while SD was associated to PC use during weekdays, tobacco use and drugs’ use. Computer uses tend to be associated among themselves. Mobile phone is associated with computer practices and with alcohol and tobacco use. Tobacco is associated with most risk behaviours. Alcohol use is associated with other substance use, computer use and violent behaviours. Violence behaviours, earlier sex and drugs use tend to be associated among themselves.

Conclusions

Sleep stealers use and risk behaviours are more prevalent in sleep deprived adolescents, but, in spite of significant individual associations, models of risk behaviours are still lacking.

Children with Traumatic Brain Injury: Associations Between Parenting and Social Adjustment

Similarities and differences in parenting practices of children (Mage = 10; range 8-13 years) with traumatic brain injury (TBI) and socially-typical controls were examined. In addition, parenting practices were examined as moderators between injury group status (TBI or socially-typical) and social adjustment in the peer group. Mothers completed assessments of parenting practices; children's peers reported about children's social adjustment. The mothers of children with TBI reported significantly lower levels of nurturance and significantly higher levels of restrictiveness than mothers of socially-typical children. In addition, mothers' nurturance moderated the relation between injury group and peer rejection, such that children with TBI were more rejected by classmates compared to their socially-typical peers at low levels of maternal nurturance. The findings are interpreted as supporting the important role parents play in the development of children with a history of TBI, as well as the implications for family-level interventions.

A Comparison of Two Models of Risky Sexual Behavior During Late Adolescence

Two models of risky sexual behavior (RSB) were compared in a community sample of late adolescents (N = 223). For the traumagenic model, early negative sexual experiences were posited to lead to an association between negative affect with sexual relationships. For the cognitive escape model, depressive affect was posited to lead to engagement in RSB as a way to avoid negative emotions. The current study examined whether depression explained the relationship between sexual trauma and RSB, supporting the cognitive escape model, or whether it was sexual trauma that led specifically to RSB, supporting the traumagenic model. Physical trauma experiences were also examined to disentangle the effects of sexual trauma compared to other emotionally distressing events. The study examined whether the results would be moderated by participant sex. For males, support was found for the cognitive escape model but not the traumagenic model. Among males, physical trauma and depression predicted engagement in RSB but sexual trauma did not. For females, support was found for the traumagenic and cognitive escape model. Among females, depression and sexual trauma both uniquely predicted RSB. There was an additional suppressor effect of socioeconomic status in predicting RSB among females. Results suggest that the association of trauma type with RSB depends on participant sex. Implications of the current study for RSB prevention efforts are discussed.

Adolescent Callous-Unemotional Traits and Parental Knowledge as Predictors of Unprotected Sex Among Youth

Risky sexual behavior among adolescents is common and results in many negative consequences. The present study investigated longitudinal predictors of adolescents' likelihood of engaging in unprotected sexual intercourse. Parental knowledge, or the extent to which parents know about their children's activities, whereabouts, and friendships, is a robust predictor of youth risk behavior, including risky sexual behavior. However, parenting practices are typically less potent as predictors of subsequent behavior among youth with high levels of callous-unemotional (CU) traits. We conducted three logistic regression models, each of which examined parental knowledge in a different way (through child report, parent report, and a discrepancy score), allowing us to examine parental knowledge, CU traits, and their interaction as predictors of adolescents' subsequent engagement in sex without a condom. Results indicated that adolescents who perceived their parents to possess greater knowledge were less likely to engage in unprotected sex. Higher parent report of parental knowledge was also related to decreased likelihood of engaging in unprotected sex, but only for adolescents with high levels of CU traits. In addition, greater discrepancy between parent and adolescent reports of parental knowledge was related to increased likelihood of engaging in unprotected sex, but only for adolescents with low levels of CU traits. Results highlight the importance of considering both parent and adolescent perceptions of parental knowledge and have important implications for prevention and intervention efforts.

Gender differences in the associations among marijuana use, cigarette use, and symptoms of depression during adolescence and young adulthood

INTRODUCTION

As prevalence of marijuana use increases, it is important that we better understand how factors like gender, cigarette use, and depression are related to marijuana use during adolescence and young adulthood. We examined longitudinal relationships among these variables in adolescents moving into young adulthood who were studied longitudinally for six years.

METHODS

1263 individuals were included in the study. Participants were oversampled for ever-smoking a cigarette at baseline, when they were 15-16 years old. Frequency of cigarette smoking and marijuana use, as well as depression symptoms, were assessed at baseline, 6, 15, 24, 60 and 72 months.

RESULTS

Cigarette use frequency and depression symptoms were associated with frequency of marijuana use (p-values<.001), particularly in adolescence, but there were important gender differences in these relationships. Specifically, symptoms of depression were related to marijuana use frequency among males (p<.001), but not females (p=.62). In addition, frequency of marijuana use was associated with increased cigarette use frequency, especially among males who had higher symptoms of depression (p<.001). However, this effect was not seen among females. Exploratory analyses suggested that relationships between frequency of use and depression are specific to marijuana, not cigarettes.

CONCLUSIONS

Marijuana use is strongly related to depression symptoms and cigarette use frequency in males, indicating that in males these detrimental factors converge, whereas in females they do not. Gender differences in the factors related to marijuana use may mean that there are different risks for and consequences from use and have implications for prevention and intervention efforts.

Risky Sexual Behavior and Substance Use among Adolescents: A Meta-analysis

This study presents the results of a meta-analysis of the association between substance use and risky sexual behavior among adolescents. 87 studies fit the inclusion criteria, containing a total of 104 independent effect sizes that incorporated more than 120,000 participants. The overall effect size for the relationship between substance use and risky sexual behavior was in the small to moderate range (r = .22, CI = .18, .26). Further analyses indicated that the effect sizes did not substantially vary across the type of substance use, but did substantially vary across the type of risky sexual behavior being assessed. Specifically, mean effect sizes were smallest for studies examining unprotected sex (r = .15, CI = .10, .20), followed by studies examining number of sexual partners (r = .25, CI = .21, .30), those examining composite measures of risky sexual behavior (r = .38, CI = .27, .48), and those examining sex with an intravenous drug user (r = .53, CI = .45, .60). Furthermore, our results revealed that the relationship between drug use and risky sexual behavior is moderated by several variables, including sex, ethnicity, sexuality, age, sample type, and level of measurement. Implications and future directions are discussed.

Resiliency as a factor protecting youths from risky behaviour: Moderating effects of gender and sport

We hypothesised that resiliency may protect adolescents against risky behaviours, and that both the practicing of sports, and gender are moderating variables in relationships between resiliency and risky behaviours. The study included 18-year-old pupils from a selection of secondary schools (n = 556). A total of 188 individuals practiced competitive sports and the remaining 368 participants were non-athletes. The participants were examined with the Resiliency Assessment Scale for Children and Adolescents (SPP-18) and with a survey containing questions and statements related to high-risk "experiments with adulthood". Adolescent athletes showed higher levels of resiliency than their peers. The power of the "Determination and Persistence in Action" effect on "Alcohol" scale differed significantly between male athletes and male non-athletes. Only in the athletes groups were higher scores on this scale reflected by lower values on the "Drugs" scale. Moreover, it is possible to observe differences in undertaking risky behaviour between male and female athletes. The analysis of risky sexual behaviour suggests that sport is a risk factor for men, and a protective factor for women. These data suggest that consistent prophylactic and psycho-educative activities, with a special attention to differences between genders, should be provided to all the adolescents, irrespective of their sport performance levels.

Sex differences in associations of school connectedness with adolescent sexual risk-taking in Nova Scotia, Canada

BACKGROUND

Associations of lower school connectedness have been seen with adolescent sexual risk behaviors, but little is known about gender differences with respect to these relationships. Understanding any such differences could contribute to better supporting the school environment to promote youth sexual health.

METHODS

We used provincially representative cross-sectional data from 1415 sexually active students in grades 10 to 12 in Nova Scotia, Canada, to determine whether lower school connectedness was associated with students' sexual risk behaviors using multivariate logistic regression, stratifying by sex.

RESULTS

In boys, lower connectedness was associated with three risk behaviors, having  ≥ 2 partners in the previous year (odds ratio [OR] 1.07; 95% confidence interval [CI] 1.01-1.13), no condom use at last intercourse (OR 1.06; 95% CI 1.01-1.12), and having unplanned intercourse due to substance use (OR 1.09; 95% CI 1.03-1.15). No such associations were seen in girls.

CONCLUSIONS

These results demonstrate that gender differences may exist for associations of school connectedness and sexual risk behaviors; connectedness may be more important for boys than for girls in this area of adolescent health. Educators should consider gender differences when designing interventions to maximize youth sexual health through school-based interventions. Further research on school connectedness and risk-taking should examine genders separately.

Epigenetic Modulation of Mood Disorders

BACKGROUND

Mood disorders are expressed in many heterogeneous forms, varying from anxiety to severe major clinical depression. The disorders are expressed in individual variety through manifestations governed by co-morbidities, symptom frequency, severity, and duration, and the effects of genes on phenotypes. The underlying etiologies of mood disorders consist of complex interactive operations of genetic and environmental factors. The notion of endophenotypes, which encompasses the markers of several underlying liabilities to the disorders, may facilitate efforts to detect and define, through staging, the genetic risks inherent to the extreme complexity of disease state.

AIMS

This review evaluates the role of genetic biomarkers in assisting clinical diagnosis, identification of risk factors, and treatment of mood disorders.

METHODS

Through a systematic assessment of studies investigating the epigenetic basis for mood disorders, the present review examines the interaction of genes and environment underlying the pathophysiology of these disorders.

RESULTS

The majority of research findings suggest that the notion of endophenotypes, which encompasses the markers of several underlying liabilities to the disorders, may facilitate efforts to detect and define, through staging, the genetic risks inherent to the extreme complexity of the disease states. Several strategies under development and refinement show the propensity for derivation of essential elements in the etiopathogenesis of the disorders affecting drug-efficacy, drug metabolism, and drug adverse effects, e.g., with regard to selective serotonin reuptake inhibitors. These include: transporter gene expression and genes encoding receptor systems, hypothalamic-pituitary-adrenal axis factors, neurotrophic factors, and inflammatory factors affecting neuroimmune function. Nevertheless, procedural considerations of pharmacogenetics presume the parallel investment of policies and regulations to withstand eventual attempts at misuse, thereby ensuring patient integrity.

CONCLUSIONS

Identification of genetic biomarkers facilitates choice of treatment, prediction of response, and prognosis of outcome over a wide spectrum of symptoms associated with affective states, thereby optimizing clinical practice procedures. Epigenetic regulation of primary brain signaling, e.g., serotonin and hypothalamic-pituitary-adrenal function, and factors governing their metabolism are necessary considerations. The participation of neurotrophic factors remains indispensable for neurogenesis, survival, and functional maintenance of brain systems.